Journal of Orthopaedic Surgery and Research 2013, 8:5
doi:10.1186/1749-799X-8-5

Published: 19 March 2013

Abstract

Background

Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction,
especially in case of DB ACL reconstruction due to more extensive procedure. The purpose
of the study was to evaluate the effect of haemarthrosis on the rehabilitation of
DB ACL reconstruction versus SB ACL reconstruction.

Methods

100 patients were divided into two groups, of SB ACL and DB ACL reconstruction consisting
of 50 patients each. An intra-articular drain was put in every patient. The pain was
evaluated till week 8 using VAS (Visual Analog Scale). The Functional outcomes were
evaluated using the Isokinetic Dynamometer at 3 and 6 months in both the groups. Muscle
bulk and Range of motion were also noted in each group.

Results

The results showed that there was statistically significant difference between the
drain amount (n = 60.3 ml in SB ACL group vs. n = 94.2 ml in the DB ACL group) and
haemarthrosis (n = 0.7 in SB ACL vs n = 1.5 in DB ACL) at week 1 post-operatively.
Also the pain outcome improved on SB ACL after day 3 (VAS, n = 1.8) as compared to
the DB ACL group (VAS, n = 3.7). The isokinetic muscle strength was found to be statistically
significantly (p value < 0.05) better in the SB ACL group in the quadriceps muscle
(both concentric and eccentric) at the end of the 3rd month. In the SB ACL group the
Quadriceps Concentric strength deficit was 22.32% as compared to 34.12% in the DB
ACL group. Both the groups had comparable flexor muscle strength at end of 3rd month.
Both the groups had comparable muscle strength after 6 months of post-operative rehabilitation
in both quadriceps and Hamstring muscle group.

Conclusion

We noted that rehabilitation of DB ACL reconstruction group lags behind that of SB
ACL reconstruction during the first 3 months due to post-operative haemarthrosis &
its effects, but show comparable results after 6 months. The muscle strength measured
isokinetically and the muscle bulk were found to be greater in the SB ACL group initially
after 3 months but was found to be similar after 6 months.